Income, insurance status contributes to rationing prescription drugs due to cost
Click Here to Manage Email Alerts
Key takeaways:
- Drug rationing was more common in patients with obesity than in patients without it.
- Drug rationing was significantly associated with lower income and lack of insurance.
SAN ANTONIO — Due to structural barriers such as low income and inadequate insurance coverage, Black and Hispanic adults were more likely to ration prescription drugs to save money, researchers reported.
The data, which also showed that people with obesity were more likely to ration prescription drugs than people without obesity, suggest possible limitations to anti-obesity medication uptake for Black and Hispanic individuals with low socioeconomic status, according to the researchers.
“We know that high prices lead to prescription drug rationing. This can be behaviors like skipping medication doses due to cost or delaying picking up a medication due to cost. In a national survey done, 79% of adults said that the cost of prescription drugs was unreasonable, and CDC data showed that 9 million U.S. adults ration prescriptions for the cost,” Alissa S. Chen, MD, MPH, postdoctoral fellow at Yale School of Medicine, said during the presentation at ObesityWeek. “GLP-1 [receptor agonists] are very expensive and could exacerbate preexisting prescription drug rationing. GLP-1s are not covered by all insurers and, outside of insurance, they cost over $1,000 per month.”
Chen and colleagues conducted a cross-sectional analysis of data from 51,720 adults (mean age, 50.1 years; 55.8% women) without diabetes who were prescribed medications from the National Health Interview Survey from 2020 to 2022. Of these, 16,768 adults had obesity with a BMI of 30 kg/m2 or higher. Researchers assessed responses to drug rationing questions from the survey to evaluate drug rationing odds across racial and ethnic groups. The study was simultaneously published in JAMA Network Open.
The primary outcome was prescription rationing defined as self-reported skipping, decreased intake or fill delays of medications to save money in the past 12 months.
Overall, 75.4% of adults were white, 14.7% were Black and 14.3% were Hispanic.
Adults with obesity were more likely to report rationing drugs at some point compared with adults without obesity (8.3% vs. 5.9%; P < .0001), according to the researchers, who also found that adults with obesity and CVD were more likely to report rationing drugs than adults with obesity but no CVD (10.3% vs. 8%; P = .005).
Black adults were more likely to report drug rationing compared with white adults (OR = 1.3; 95% CI, 1.1-1.6) and Hispanic adults were more likely to report drug rationing compared with non-Hispanic adults (OR = 1.4; 95% CI, 1.1-1.7) in the unadjusted analysis. In the analysis adjusted for age, sex, income and insurance, researchers observed no differences in drug rationing based on race and ethnicity.
However, drug rationing was significantly associated with incomes 0 to 100% of the federal poverty level vs. incomes 400% or higher (OR = 7; 95% CI, 3-5.3). In addition, drug rationing was significantly associated with lack of insurance vs. private insurance (OR = 3; 95% CI, 2.2-3.9).
“Structural barriers impede access to medications for Black and Hispanic adults with obesity, which might worsen if there’s not expanded coverage for GLP-1s,” Chen said. “It’s possible that broader insurance coverage could ameliorate some of these issues.”
Reference:
Collapse
Chen AS, et al. Oral-078. Presented at: ObesityWeek; Nov. 3-6, 2024; San Antonio.
Read more about
Click Here to Manage Email Alerts